Praise for OOH vets

Re: Praise for OOH vets

Joyce Whitehead — Fri, 24 May 2013 19:56:49 GMT

I agree that doctors often have no idea of costs. I had a gp in a few weeks ago for a consultation for her cat. She was worried it had a skin problem but in fact it just had several deep mats, which I clipped off in the surgery, after making sure there were no other problems and discussing parasites and grooming in general. The consultation lasted our usual 10 minutes. As we are in the north our prices are quite reasonable, so the fee was under £25 for a consultation. The doctor complained at the reception desk, so our receptionist explained this was our standard first consultation fee for seeing the vet. The doctor responded that this wasn't her first consultation as she had the cat vaccinated last year! However, she did pay.

Re: Praise for OOH vets

Virginia Campbell — Fri, 24 May 2013 19:26:10 GMT

Hmm...the NHS may be a bit financially inefficient here and there; but would a privatised system be so much more efficient that we would end up able to pay the whole stratum of middlemen (insurance companies) in addition to the medics themselves, more easily than we pay the NHS?

I get the point about hypochondriac idlers clogging up the system, but better this than the merely unfortunate getting stuffed. (as an example, say a new grad vet who can't get a job for a year through no fault of their own; gets tempted by cheap health insurance rather than "human Petplan" as a way of saving money, gets broken and discovers after reading through 200 pages of fine print that they're not adequately covered).

Also, if the system gets privatised, consider the reason for which an adult female (big section of vetsurgeon.org's population demographic) is most likely to visit hospital. Going private for childbirth may be great if everything goes swimmingly and you want chocolates on the pillow and a better class of person to compare your plans for Greek lessons for your newborn children; but if things are rapidly going downhill, you're better off in an NHS hospital. Lots of chocolates-on-the-pillow births would be more lucrative for private health companies; they might not be so keen on dealing with the high-risk, gonna-get-sued births. Over 35? Right, your premium is going to make that of a 10 year old English Bulldog seem like buttons.

I don't think it's true to say that a lot doctors can't be arsed cos they get paid whether or not they do a good job. After all, the majority of we vet assistants here in the UK are paid a plain salary, not on production, and almost all of us do our jobs to the best of our abilities.

It probably is a good idea to let people know how much their treatment has cost the NHS; I don't think it will make a scrap of difference to the patients (I think the majority of the PDSA clients who are given the fake invoice showing how much their pet's treatment would have cost just use it as loo roll) but it would be good for the doctors to know. My best friend is an obs+gynae reg and brilliant at her job: I asked her how much a human Caesar and a human "spay" cost....she had no idea.

[quote user="Simon Neuhoff"]The NHS has its flaws but I would not swap it for the private health care systems in South Africa or the US.[/quote]

Having read Lionel Shriver's excellent novel "So Much For That", neither would I.

Re: Praise for OOH vets

David Mills — Fri, 24 May 2013 18:05:30 GMT

No more anecdotes from me - though I agree with Mrs M on this - but spare a thought for (some of) the clinical people working in the system who despair as much as people outside the system.

There was a great series on BBC called the Keeping Britain Alive: the NHS in a day which was illuminating - I think its still available on iplayer.

The impression I got is the NHS is a huge, unwieldy behemoth too big, with too many departments, too many positions, and too much territoriality to function at all efficiently. The amount of waste is astonishing. Yes, there are some pillock doctors working there who presume they can spend what they like and someone else will pick up the bill. And there are those who seem to think they are charity workers who should be hailed, and everyone they treat should be grovellingly grateful. Thankfully these appear mainly to be surgeons who you never see, or young upstarts who are quickly scythed down by taking blood for 2y and working 80h weeks. For the most part, people seemed genuinely hardworking and focused on their jobs. The real criminals in it all are the swathes of middle managers - arts graduates brought in on 'fast track' courses handing down ivory tower initiatives from up high - to consider the inflated waghe these people are drawing and the tripe they spout made my blood boil.

But it is abundantly clear that chucking money at it isn't going to work. The only way it stands any chance of efficiently treating an expanding, ageing population is by part-privatising. When it is run on economical, open market competition terms, rather than political, patient care will improve.

Re: Praise for OOH vets

Hannah Wynne Richards — Fri, 24 May 2013 18:02:50 GMT

Simon Yes Better privatise it. Then I could just pay £3600 pa to a private company for my own healthcare-and not subsidise the idle

Wynne

Re: Praise for OOH vets

Cat Henstridge — Fri, 24 May 2013 15:50:10 GMT

[quote user="Gillian Mostyn"]

Next check up on a melting ulcer? 1 week.

Emergency treatment? Excellent. Out-patient treatment -in my experience with this and other problems - dreadful.

[/quote]

Time to go private?

Re: Praise for OOH vets

Gillian Mostyn — Fri, 24 May 2013 14:55:33 GMT

update:

check up today. Waited 2 hours for a booked appointment. Saw same doctor who said that the ulcer hasn't really changed, so he would like the consultant (expert on corneal surgery apparently) to have look.....but then discovered that because the appointments had run so late the consultant had already left.

Next check up on a melting ulcer? 1 week.

Emergency treatment? Excellent. Out-patient treatment -in my experience with this and other problems - dreadful.

Re: Praise for OOH vets

Mark Hedberg — Fri, 24 May 2013 12:38:10 GMT

[quote user="Simon Neuhoff"]

Ahh - but you would still be paying for the government health care services - they would just be so appallingly bad that you didn't dare to use them.

[/quote]

So no change, then?

Re: Praise for OOH vets

Simon Neuhoff — Fri, 24 May 2013 09:05:43 GMT

[quote user="Hannah Wynne Richards"]

Simon If the amount I contribute annually to the NHS could be reduced to £3600, I'd be laughing (all the way to the bank)

If it can possibly be taken out of the tax system-then take it out is my philosophy. Let the people who work keep their money

Wynne

[/quote]

Ahh - but you would still be paying for the government health care services - they would just be so appallingly bad that you didn't dare to use them.

Re: Praise for OOH vets

tess — Thu, 23 May 2013 22:13:12 GMT

[quote user="Michael Woodhouse"]

[quote user="tess"]We forgot to take my son's inhaler with us when visiting mum for the weekend. He only needs it occ if hay fever symptoms are bad. After waking through a field of buttercups he got pretty wheezy so phoned NHS 24 to see if we could be prescribed one.[/quote]

Most pharmacists will supply items like inhalers as a private emergency prescription:

http://www.nhs.uk/chq/pages/1011.aspx?categoryid=73&subcategoryid=105

[/quote]

That's really handy to know- I didn't know that service existed. I've used the minor ailments service a few times, which allows children to have free OTC meds.

Re: Praise for OOH vets

Hannah Wynne Richards — Thu, 23 May 2013 19:44:19 GMT

Simon If the amount I contribute annually to the NHS could be reduced to £3600, I'd be laughing (all the way to the bank)

If it can possibly be taken out of the tax system-then take it out is my philosophy. Let the people who work keep their money

Wynne

Re: Praise for OOH vets

Bob Russell — Thu, 23 May 2013 11:37:20 GMT

I have taken advantage of this in the past for epilepsy medication. Last time I tried it I found the cost for a months supply had gone from £14 to just under £300 so arranged to have some picked up from home (a lot cheaper!).

Re: Praise for OOH vets

Michael Woodhouse — Thu, 23 May 2013 00:21:28 GMT

Most pharmacists will supply items like inhalers as a private emergency prescription:

http://www.nhs.uk/chq/pages/1011.aspx?categoryid=73&subcategoryid=105

Re: Praise for OOH vets

mariette asselbergs — Wed, 22 May 2013 18:15:59 GMT

My (vet) colleague had a heart attack last week on a Sunday at 03.00 o'clock. With screaming ambulance into hospital, two stents in through the radial artery, and 2 hours later back home, alive, on his feet and on 6 weeks off work rest.

NHS is brilliant for emergencies.

Mariette

Re: Praise for OOH vets

tess — Tue, 21 May 2013 19:16:31 GMT

We forgot to take my son's inhaler with us when visiting mum for the weekend. He only needs it occ if hay fever symptoms are bad. After waking through a field of buttercups he got pretty wheezy so phoned NHS 24 to see if we could be prescribed one. We were told to go to A&E where I explained that just needed to collect an inhaler. . His SATs were 95 so not too bad but he needed treatment . No one would just prescribe the b*****y inhaler. we were put in a cubicle and left for 2 hours with no treatment before someone finally came to look at him. Then there was a big fuss about how they couldn't just give out inhalers from A&E and they would have to "see what they could do". Eventually he was given one but we weren't allowed to leave until he sat there for half a hour after having it. What made it more laughable was that being in an air conditioned space for all that time meant the symptoms started to go on their own. What a total waste of time for all concerned.

On the subject of doctors doing physical exams, it amazes me that they have the magical powers of "remote diagnosis".

I try to avoid the whole system as much as poss.

Re: Praise for OOH vets

Simon Neuhoff — Tue, 21 May 2013 16:49:34 GMT

I am not at all convinced that privatising the NHS would improve things.

My wife and I have had mixed experiences at NHS hospitals since arriving in this country - but mostly they have been good. Certainly her maternity care has been exceptional.

I have numberous friends and family who live in South Africa and get what they are told is first rate private health care. It leads to a number of interesting things - one striking example is that a caesarian is very much the norm for ALL pregnancies - they have done such a good job of brainwashing people into thinking it is the best way forward that those trying to opt for natural birth are considered very odd indeed. The other thing is that the sum of money is very limited - once you have used up your allowance for the year then that is it. Mty father-in-law struggled massively to have a second knee replacement and a friend is having to pay in full for her emergency surgery on a perculiar cyst in her neck (depsite having a very expensive private medical insurer) because she has used up her allowance this year on maternity and other costs. Medical insurance in South Africa costs over £300/month for basic plans.

I had occasion to use a private A&E on a recent trip to South Africa - it was the only option at the time. I paid in cash (made to pay up front before they would allow me into the cubicle) and was seen by a slovenly chap in Tshirt and tracksuit pants. He was thoroughly disinterested in what was quite a deep and contaminated wound and after a cursory wipe sutured it so poorly that any one of my nurses would have been better.

So be careful what you wish for! The NHS has its flaws but I would not swap it for the private health care systems in South Africa or the US.

Re: Praise for OOH vets

patrick murphy — Tue, 21 May 2013 12:06:28 GMT

I went yesterday for an out patient procedure at a treatment centre, which is operated privately for the NHS patients, and it was fantastic. better even than private treatment that I have received. I did not even have time enough to figure out what book and what page I had last been reading on my kindle, and I was called, and stuff done immediately.what is wrong with these places doing suitable outpatient stuff, if they can do it better and generate a profit for the owners than the monoliths, which of course do have their places for teaching and serious stuff. is it not comparable to referring pur patients privately c.f. uni's?

Re: Praise for OOH vets

Gillian Mostyn — Tue, 21 May 2013 07:47:11 GMT

[quote user="Michael Woodhouse"]This could have happened anyway.[/quote]

I think this had already happened - she just didn't notice. The doctor who examined her yesterday said so, using different words! The medication she was given is absolutely what she should have been on though...... it wouldn't have made any difference to treatment at that stage.

Re: Praise for OOH vets

Niall Connell — Mon, 20 May 2013 22:29:29 GMT

[quote user="Gillian Mostyn"]

update for anyone interested:

Grandma's corneal graft/own cornea junction has perforated and is leaking aqueous. Unfortunately she didn't get seen till 6pm so we have been sent home and have to go to a different hospital tomorrow to see a consultant to discuss what to do next - they may place a bandage lens but increased risk of infection getting worse....

And to think I had to battle both Saturday and today to get her seen...... . I also knew the doc on Saturday didn't do a thorough exam..... !!!

[/quote]

Sounds awful. Best wishes for a speedy recovery, Gillian!

Re: Praise for OOH vets

Mark Hedberg — Mon, 20 May 2013 22:19:29 GMT

Fingers crossed...don't suppose one of the vet ophthalmologists on here does OOH? (I mean that nicely, you'd get seen quick!)

Re: Praise for OOH vets

Joyce Whitehead — Mon, 20 May 2013 21:41:38 GMT

Fingers crossed here too Gillian, hope things get sorted in the morning.

Re: Praise for OOH vets

Michael Woodhouse — Mon, 20 May 2013 21:03:12 GMT

Gillian - sounds nasty.

[quote user="Gillian Mostyn"] I also knew the doc on Saturday didn't do a thorough exam..... !!![/quote]

This could have happened anyway.

Re: Praise for OOH vets

Anne Seawright — Mon, 20 May 2013 20:54:02 GMT

Fingers crossed for her Gillian.

Re: Praise for OOH vets

Gillian Mostyn — Mon, 20 May 2013 20:33:10 GMT

update for anyone interested:

And to think I had to battle both Saturday and today to get her seen...... . I also knew the doc on Saturday didn't do a thorough exam..... !!!

Re: Praise for OOH vets

Bob Russell — Mon, 20 May 2013 16:52:04 GMT

[quote user="Toby Birch"]I have said for years that the NHS effectively needs to be run like a private company to make it work. Make each GP/Hospital etc private and give the patient the choice of where to go. Patient is given the bill so they know what it is but it is actually paid centrally. I know there are problems with this but a starting point for reconstructing the system...

[/quote]

A form of this is in the new NHS reforms. The idea is that your friendly, smiling family GP has a budget that he or she can spend on your behalf to get efficiency in treatment and better service.

The reality is, of course very different! That friendly, caring GP is as likely to rub his/her hands in glee at the extra income or be so bogged down that things are delegated to managers.

Letting patients know how much they have just cost the NHS may encourage them to use it more to get better value for money!

Re: Praise for OOH vets

Thomas Johnson — Mon, 20 May 2013 16:28:31 GMT

[quote user="Gillian Mostyn"]

[quote user="Thomas Johnson"]Neither the public nor private sector have a monopoly on running good businesses and providing good value for money.[/quote]

Hmm.... struggling to think of a good business in the public sector......

[/quote]

It may not be perfect but Network Rail, which is to all intents and purposes in the public sector whatever else the government tries to tell you, is a significant improvement on Railtrack.